MEDICARE: MR. GEORGE JOSEPH SCHLERETH MA, BCBA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1528464112
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. GEORGE JOSEPH SCHLERETH MA, BCBA

Provider Business Mailing Address
First Line	:	11510 WISTERIA CT
Second Line	:
City	:	SWAN POINT
State	:	MD
Zip	:	20645-2117
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	11510 WISTERIA CT
Second Line	:
City	:	SWAN POINT
State	:	MD
Zip	:	20645-2117
Country	:	US
Telephone Number	:	518-577-0955
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/10/2014
Last Update Date	:	11/10/2014

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Directions to “ MR. GEORGE JOSEPH SCHLERETH MA, BCBA” Practice Location

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